Secondary jaw aneurysmal bone cyst (JABC)--a possible misnomer? A review of literature on secondary JABCs, their pathogenesis and oncogenesis.

CONTEXT: Aneurysmal bone cysts are rare pseudocysts, commonly seen in long bones and vertebral column. Although a well described and reported lesion, many misconceptions still prevail regarding their etiopathogenesis. Many of the reported cases of jaw aneurysmal bone cysts (JABC) present with another bone pathology. AIMS: The purpose of this review was to evaluate the incidence of neoplastic lesions occurring simultaneously with a JABC (in contrast to primary JABCs). Any pathogenetic and oncogenetic association between primary and secondary jaw ABCs has been reviewed and discussed. SETTINGS AND DESIGN: A methodical narrative review of literature was performed, given the incidence of mostly case reports on this topic. METHODS AND MATERIAL: A methodical electronic search of Pubmed, Pubmed Central, Medline and Cochrane databases was performed for reported cases of JABC. These articles were analysed and segregated into primary and secondary ABC and, if secondary, the lesion it concurrently occurred with. Another search was conducted to yield articles discussing the cytopathogenetic and oncogenetic origins of ABCs. RESULTS AND CONCLUSIONS: About 15% of the ABCs reported were of secondary nature. Amongst the associated lesions, cement-ossifying fibroma and ossifying fibroma were the most common, followed by fibrous dysplasia and central giant cell granuloma. No ABCs were associated with metastatic changes. The search for histopathogenesis pointed to a specific cytogenetic abnormality as the origin of primary ABCs, with USP6 as its main oncogene and spindle cell as the neoplastic cell, unlike with secondary ABCs, suggesting that they are distinct pathological processes.

A clinical study of cysts of the maxillofacial region; and an assessment of clinico-radiologico-pathological variables affecting the formulation of a comprehensive patient need based treatment plan.

OBJECTIVES: Evaluation of clinical presentation of cystic lesions of the maxillofacial region, their relation to radiological picture, and treatment planning so as to plan and execute a patient need based treatment modality after co-relating it to the eventual histopathological diagnosis. METHODS: 25 cases with clinico-radiological diagnosis of a cyst were selected and treated, and the diagnosis was co-related to the eventual histopathological diagnosis. The patients were followed up for at least 3 months (3-12 months). An attempt was made to underline patient and lesion related variables having a bearing on the choice of treatment modality in each case. RESULTS: Out of 25 patients, 28% were females and 72% males. Commonly affected age groups were 11-20 (40%) and 31-40 years (24%). 76% of 25 patients complained of swelling on the first visit. 96% lesions were related to jaws, of which 15 were in the mandible and 9 were in the maxilla. 58.33% bone lesions had cortical expansion. 92% lesions were confirmed to be cysts histopathologically. Two were ameloblastomas. 80% patients underwent enucleation with various adjunctive procedures. 32% patients faced temporary post operative complications. No recurrences were observed. Radiological presentation of lesions and patient's age were found to be the two most important radiological and clinical variables affecting treatment planning. CONCLUSIONS: A comprehensive patient need based treatment plan can be reached only after taking various patient and lesion related variables (which may manifest as clinical, radiological or histological parameters) into consideration.

Styloid-stylohyoid syndrome.

This is a case report of Eagle's syndrome due to osseous metaplasia of the stylohyoid apparatus treated conservatively by injection of a local anesthetic - steroid combination. The incidence, etiopathogenesis, classification, clinical picture and various approaches to treatment of ossified stylohyoid ligament associated with Eagle's syndrome have been discussed. Anterolateral glossodynia, which is a previously unreported finding in Eagle's syndrome, and its possible etiology, has also been discussed.

Non-surgical endodontics in retreatment of periapical lesions - two representative case reports.

This article reports non-surgical endodontic retreatment of two patients with persistent or recurrent periapical lesions, who had previously undergone surgical and non-surgical endodontic therapy respectively. It further discusses and reviews the relevance of classification of periapical lesions, the explanation behind healing of periapical lesions by endodontic therapy alone, causes of persistence of periapical lesions, choice of treatment modalities (whether surgical or non - surgical) and materials such as intracanal medicaments and irrigants for optimal healing. Key words:Non-surgical, retreatment, periapical, calcium hydroxide, chlorhexidine irrigation.